Individual
MARY MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
722 N CALIFORNIA ST, SUITE # 7, SOCORRO, NM 87801-5221
(505) 740-2465
Mailing address
34 B MONTOYA RD., PO BOX 475, SAN ANTONIO, NM 87832-0475
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3099
NM
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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